AQUEOUS MISDIRECTION SYNDROME MANIFESTING AS MYOPIC SHIFT AFTER CATARACT SURGERY

To present a case of postoperative myopia due to aqueous misdirection syndrome following cataract surgery

Tritya Eye Clinic, Surabaya, East Java, Indonesia

 A case report

A 72-year-old man reported blurred vision on the right eye three weeks after uneventful cataract surgery. He had phacoemulsification and in-the-bag fixation of a posterior chamber intraocular lens (IOL). A plate-haptic intraocular lens (IOL) was implanted. The visual acuity developed refractive surprise approximately minus 3.0 diopters (D). On examination, anterior chamber shallowing, mid-mydriatic pupil, and the adherent of anterior surface of the IOL and pupillary margin were founded. This condition was diagnosed as aqueous misdirection syndrome. Anterior vitrectomy and intraocular lens (IOL) exchanged was planned to resolve the problems. One week postoperatively, the BCVA was 6/15. Anterior chamber was clear and deep. The BCVA had improved to 6/6 after one month postoperatively.

The aqueous misdirection syndrome is a rare but potentially significant postoperative complication of phacoemulsification. This condition is marked by myopic shift and anterior chamber shallowing, which can occur with or without an increase in intraocular pressure. The surgical procedure has demonstrated efficacy in the restoration of these conditions.